儿童嗜酸性粒细胞增多和全身症状药物反应 (DReSS) 的临床表现和诊断:范围界定综述

IF 8.4 2区 医学 Q1 ALLERGY Clinical Reviews in Allergy & Immunology Pub Date : 2024-03-11 DOI:10.1007/s12016-024-08983-7
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引用次数: 0

摘要

摘要 有效治疗伴有嗜酸性粒细胞增多和全身症状的药物反应(DReSS)需要早期诊断和密切监测。由于嗜酸性粒细胞增多和全身症状(DReSS)的发病率低、临床表现各异、缺乏(儿科)诊断标准和临床实践指南,因此诊断儿童 DReSS 尤其具有挑战性。我们根据《系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)指南进行了一次范围综述,总结了儿童(0-18 岁)DReSS 的临床表现和诊断过程。来自 644 名患者的数据显示,与成人相比,DReSS 在儿童中的表现有所不同。与成人相比,儿童受累的器官更多,包括心脏和呼吸系统受累的比例更高。6 岁儿童似乎更容易出现神经系统症状。相反,嗜酸性粒细胞增多、水肿和肾脏受累在儿童中较少见。迄今为止,抗癫痫药物是最常见的致病药物类别,但随着儿童年龄的增长,受影响药物的种类也在增加。这项研究强调,患有 DReSS 的儿童不仅与成人不同,而且不同年龄段的儿童之间也存在差异。因此,有必要建立针对儿童的诊断标准。这些努力将促进 DReSS 的早期诊断,并有可能改善为儿童及其家庭提供的临床护理。
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Clinical Presentation and Diagnosis of Drug Reaction with Eosinophilia and Systemic Symptoms (DReSS) in Children: A Scoping Review

Abstract

Effective treatment of drug reactions with eosinophilia and systemic symptoms (DReSS) requires early diagnosis and close monitoring. Diagnosing DReSS is especially challenging in children due to a low incidence rate, heterogeneous clinical presentation, and a lack of (pediatric) diagnostic criteria and clinical practice guidelines. We performed a scoping review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to summarize the clinical presentation and diagnostic process of DReSS in children (aged 0–18 years). Data from 644 individuals showed that DReSS manifests differently in children compared to adults. Children have a higher number of organs involved, including higher rates of cardiac and respiratory involvement compared to adults. Children < 6 years of age appear more prone to develop neurologic symptoms. Conversely, eosinophilia, edema, and kidney involvement are less frequently observed in children. Anti-seizure medications are by far the most common causative drug class, but the range of implicated drugs increases as children get older. This study highlights that children with DReSS not only differ from adults but also that differences exist between children of different ages. As such, there is a need to establish pediatric-specific diagnostic criteria. These efforts will promote earlier diagnosis of DReSS and likely lead to improved clinical care offered to children and their families.

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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
期刊最新文献
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